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Surgical treatment for pelvic bone metastases

    Andreas F Mavrogenis

    Andreas F Mavrogenis was born in Greece. He studied Medicine and Orthopedics at Athens University Medical School, Greece. He was a clinical and Research Fellow-Consultant Orthopaedic Surgeon in Orthopedic Oncology at the Istituto Ortopedico Rizzoli, Bologna, Italy. He is currently a Consultant Orthopedic Surgeon at the Department of Orthopaedic Surgery and Musculoskeletal Oncology of Attikon University Hospital, Athens University Medical School, Greece.

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    ,
    Eugenio Brunocilla

    Eugenio Brunocilla is Holder of teaching in Urology, General Surgery, Oncology, Gynecology and Geriatric Specialization School, University of Bologna, Italy. He is a full member of European Association of Urology. He is also author and coauthor of national and international papers in particular dealing with urological cancer surgery and pathology and with the study of urinary lithiasis (inhibitors of the crystallization).

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    Giuseppe Bianchi

    Giuseppe Bianchi obtained his degree in Medicine at the Medical School of University of Bologna, Italy in 1995 and he is specialist in Orthopedics and Traumatology since November 2000. After a clinical and research fellowship at Hospital for Special Surgery of New York, USA, he is currently Junior Associate at Oncological Department of Istituto Ortopedico Rizzoli, Italy and he is Member of the European Muscoloskeletal Society.

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    Nicola Fabbri

    Nicola Fabbri is an Orthopedic Surgeon at Istituto Ortopedico Rizzoli in the Department of Musculoskeletal Oncology, Italy. His main areas of clinical research and interest are musculoskeletal oncology and tumor surgery, including both limb salvage surgery and amputations, total joint replacement and skeletal reconstruction, focusing on severe bone loss and new porous metal materials.

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    &
    Pietro Ruggieri

    Pietro Ruggieri, board of Orthopaedics in 1987 and PhD in Oncology in 1991, was trained by M Campanacci and M Mercuri during his surgeon career. He is Director of Clinic IV Orthopaedic Oncology at University of Bologna, Rizzoli Institute, Italy and the President of ISOLS. He is the author of more of more than 400 publications and lecturer in more than 300 international congresses. His main field of research is reconstructive surgery in musculoskeletal oncology.

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    Published Online:21 Mar 2012https://doi.org/10.2217/ebo.11.360
    Abstract:

    The pelvis is the second most common site of bone metastases after the spine. Pain, bone destruction causing mechanical instability and pathological fractures are the most common manifestations. Traditional treatments for pelvic bone metastases include surgery and external beam radiation therapy. If bone destruction is limited, analgesics, radiation therapy, hormonal therapy, chemotherapy, embolization, bisphosphonates and minimally invasive techniques such as radiofrequency ablation, osteoplasty and cryosurgery can be considered [6]. Lesions of the hemipelvis not directly involving the hip joint, pathological fractures sustained through an area of the pelvis other than the acetabulum and avulsion fractures of the anterior superior/inferior iliac spines, iliac crest and pubic rami seldom require surgical stabilization and reconstruction because pelvic stability is maintained. By contrast, diffuse involvement of the pelvis, impending or existing pelvic discontinuity and bony destruction of the periacetabular area warrants surgical treatment [4,7–10]. The use of poly(methyl methacrylate) to bridge large defects and suspend an acetabular component, conventional total hip replacement, massive allograft or saddle megaprosthetic reconstruction are likely to fail because of the deficient bone and the progressive osteolytic disease [1].

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